title: Quality of life 12 years after on-pump and off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  To assess whether the use of either the on-pump or the off-pump method affects changes in health-related quality of life (QOL) in the long term after coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  Four hundred and fifty-two (89.0%) of the 508 patients in a single institution were operated on-pump and 56 (11.0%) were operated off-pump. The RAND-36 Health Survey (RAND-36) was used as an indicator of QOL. Assessments were performed preoperatively and repeated 1 year and 12 years later. Symptomatic status was estimated according to New York Heart Association class.
  
  
  RESULTS
  After 1 year, on-pump patients improved significantly (P<0.001) in all eight RAND-36 dimensions. Also, in off-pump patients, positive changes were observed in all RAND-36 dimensions and these changes were statistically significant (P<0.05) in six dimensions. Despite an ongoing decrease in QOL over the 12-year follow-up, on-pump patients still maintained a significant (P<0.05) improvement in all and off-pump patients in seven out of eight RAND-36 dimensions. A highly significant (P<0.001) pattern of change after 1 year was observed in the RAND-36 Mental Component Summary and Physical Component Summary scores in both operative groups, and despite the general declining trend, significant improvement was maintained during the 12-year follow-up time. Both groups showed almost identical relief from anginal symptoms at 12 years.
  
  
  CONCLUSIONS
  A majority of patients experience significant improvement in health-related QOL in the long term after CABG. Cardiopulmonary bypass has no impact on patients' subsequent health-related QOL.
authors.affiliation: aHeart Center, Tampere University Hospital bSchool of Medicine cSchool of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Otso
authors.initials: O
authors.lastname: Järvinen
authors.forename: Matti
authors.initials: M
authors.lastname: Hokkanen
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000401:mortality; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000401:mortality; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005387:Finland; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome